Öz
Aim: To investigate the incidence of adenomyosis in histerectomy
cases.
Material and Method: The incidence of adenomyosis was evaluated in cases who had undergone hysterectomy of any cause between January 2005-December 2015.
Results: In 58% of 205 cases with vaginal hysterectomy the final histopathological evalaution was adenomyosis. The indication
for operations of these cases was: pelvic organ prolapsus (n: 117,
57%), endometrial hyperplasia (n: 40, 19.5%), servical displasies
(n: 15, 7.3%), postmenoposal bleeding (n: 11, 5.3%), treatment
resistant menometroragia (n: 10, 4.9%), leimyoma (n: 9, 4.4%),
endometrial polip (n: 2, 1%) and mole hydatiform (n: 1, 0.5%). An
additional operation was performed together with vaginal hysterectomy in 64.8% (n: 133) of the cases. The additional operations
were sistorectosel operation (n: 46, 34.5%), rektosel operation (n:
26, 19.5%), sistosel operation (n: 22 16.5%), sacrospinosis fixation
(n: 21, 15.7%) and transobturatuar tape.
Conclusion: Preoperative adenomyosis can be diagnosed more
frequently between the ages 40–50 years. Especially in treatment
resistant menometroragia cases adenomyozis should be thought
in aethiology
Anahtar Kelimeler
Kaynakça
- 1. Pernoll ML. Obstetrik ve Jinekoloji El Kitabı. Ayhan A (Çeviren) 10. baskı, Ankara: Palme, 2002:755–67. 2. Hunter WC, Smith LL, Reiner WC. Uterine adenomyosis; incidence, symptoms and pathology in 1856 hysterectomies. Am J Obstet Gynecol 1947;53(4):663–8. 3. Bird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus-revisited. Am J Obstet Gynecol 1972;112(5):583–93. 4. Israel SL, Woutersz TB. Adenomyosis: a neglected diagnosis. Obstet. Gynecol 1959;14(2):168–73. 5. Kavak SB. Histerektomi materyallerinde adenomyozis sıklığının araştırılması. Fırat Tıp Dergisi 2009;14(4):247–9. 6. Kunz G, Beil D, Huppert P, M. Noe S. Kissler G. Leyendecker. Adenomyosis in endometriosis prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod 2005;20(8):2309–16. 7. Serin İS, Özçelik B, Öztürk F, Yılmaz MO, Başbuğ M, Ökten T. Adenomyosis uteri: clinicopathologic analyses of 460 cases. Gynecol Obstet Reprod Med 2002;8(1):34–6. 8. Fong YF, Singh K. Medical treatment of a grossly enlarged adenomyotic uterus with the levonorgestrel-releasing intrauterine system. Contraception 1999;60(3):173–5. 9. Sheng J, Zhang WY, Zhang JP, Lu D. The LNG-IUS study on adenomyosis: a 3-year follow-up study on the efficacy and side effects of the use of levonorgestrel intrauterine system for the treatment of dysmenorrhea associated with adenomyosis. Contraception 2009;79(3):189–93. 10. Igarashi M, Abe Y, Fukuda M, Ando A, Miyasaka M, Yoshida M et al. Novel conservative medical therapy for uterine adenomyosis with a danazol-loaded intrauterine device. Fertil Steril 2000;74(2):412–3. 11. Lin J, Sun C, Zheng H. Gonadotropin-releasing hormone agonists and laparoscopy in the treatment of adenomyosis and infertility. Chin Med J 2000;113(5):442–5. 12. Reinhold C, McCharty S, Bret PM, Mehio A, Atri M, Zakarian R et al. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 1996;199:151–8. 13. Shaikh H, Khan KS. Adenomyosis in pakistani women: four year experience at the Aga Khan University Medical Centre, Karachi. J Clin Pathol 1990;43(10):817–9. 14. Vercellini P, Parazzini F, Oldani S, Panazza S, Bramante T, Crosignani PG. Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics. Hum Reprod 1995;10(5):1160–2. 15. Parazzini F, Vercellini P, Panazza LC, Chatenoud L, Oldani S, Crosignani PG. Risk factors for adenomyosis. Hum Reprod 1997;12(6), 1275–9. 16. Emge LA. The elusive adenomyosis of the uterus. Am J Obstet Gynecol 1962;83:1541–63. 17. Azziz R. Adenomyosis in pregnancy. J. Reprod Med 1986;31(4):224–7. 18. Matalliotakis IM, Katsikis IK, Panidis DK. Adenomyosis: what is the impact on fertility? Curr Opin Obstet Gynecol 2005;17(3):261–4. 19. Takahashi K, Nagata H, Kitao M. Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis. Nippon Sanka Fujinka Gakkai Zasshi 1989;41(11), 1849–50. 20. Lee NC, Dicker RC, Rubin GL, Ory HW. Confirmation of the preoperative diagnosis for hysterectomy. Am J Obstet Gynecol 1984;150(3):283–7. 21. Kim MH. Dysfunctional uterine bleeding. In: Copeland IJ editor. Textbook of Gynecology 15t ed. WB Saunders Comp 1993;391–7.
Öz
Amaç: Histerektomi yapılan olgularda adenomyozis insidansının
araştırılması.
Materyal ve Metot: Ocak 2005-Aralık 2015 tarihleri arasında değişik nedenlerle vajinal histerektomi yapılan olgularda adenomyozis
insidansı araştırıldı.
Bulgular: Vajinal histerektomi yapılan 205 olgunun 58’inde (%28,3)
final histopatolojide adenomyozis tespit edildi. Bu olguların operasyon endikasyonları; pelvik organ prolapsusu (n: 117, %57), endometrial hiperplaziler (n: 40, %19,5), servikal displaziler (n: 15,
%7,3), postmenopozal kanama (n: 11, %5,3), tedaviye dirençli menometroraji (n: 10, %4,9), leiomyomlar (n: 9, %4,4), endometriyal polip (n: 2, %1) ve mol hidatiform (n: 1, %0,5) idi. Bu olguların
%64,8’ine (n: 133) vajinal histerektomi ile beraber ek operasyon
uygulandı. Uygulanan ek operasyonlar; sistorektosel operasyonu
(n: 46, %34,5), rektosel operasyonu (n: 26, %19,5), sistosel operasyonu (n: 22 %16,5), sakrospinöz fiksasyon (n: 21, %15,7) ve trans
obturatuar tape uygulamasıydı.
Sonuç: Preoperatif adenomyozis tanısı, olguların bir bütün halinde
değerlendirilmesi halinde özellikle 40–50 yaş grubunda daha sık
konulabilir. Özellikle tedaviye dirençli menometroraji olgularında
etyolojide adenomyozis olabileceği akılda tutulmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Pernoll ML. Obstetrik ve Jinekoloji El Kitabı. Ayhan A (Çeviren) 10. baskı, Ankara: Palme, 2002:755–67. 2. Hunter WC, Smith LL, Reiner WC. Uterine adenomyosis; incidence, symptoms and pathology in 1856 hysterectomies. Am J Obstet Gynecol 1947;53(4):663–8. 3. Bird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus-revisited. Am J Obstet Gynecol 1972;112(5):583–93. 4. Israel SL, Woutersz TB. Adenomyosis: a neglected diagnosis. Obstet. Gynecol 1959;14(2):168–73. 5. Kavak SB. Histerektomi materyallerinde adenomyozis sıklığının araştırılması. Fırat Tıp Dergisi 2009;14(4):247–9. 6. Kunz G, Beil D, Huppert P, M. Noe S. Kissler G. Leyendecker. Adenomyosis in endometriosis prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod 2005;20(8):2309–16. 7. Serin İS, Özçelik B, Öztürk F, Yılmaz MO, Başbuğ M, Ökten T. Adenomyosis uteri: clinicopathologic analyses of 460 cases. Gynecol Obstet Reprod Med 2002;8(1):34–6. 8. Fong YF, Singh K. Medical treatment of a grossly enlarged adenomyotic uterus with the levonorgestrel-releasing intrauterine system. Contraception 1999;60(3):173–5. 9. Sheng J, Zhang WY, Zhang JP, Lu D. The LNG-IUS study on adenomyosis: a 3-year follow-up study on the efficacy and side effects of the use of levonorgestrel intrauterine system for the treatment of dysmenorrhea associated with adenomyosis. Contraception 2009;79(3):189–93. 10. Igarashi M, Abe Y, Fukuda M, Ando A, Miyasaka M, Yoshida M et al. Novel conservative medical therapy for uterine adenomyosis with a danazol-loaded intrauterine device. Fertil Steril 2000;74(2):412–3. 11. Lin J, Sun C, Zheng H. Gonadotropin-releasing hormone agonists and laparoscopy in the treatment of adenomyosis and infertility. Chin Med J 2000;113(5):442–5. 12. Reinhold C, McCharty S, Bret PM, Mehio A, Atri M, Zakarian R et al. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 1996;199:151–8. 13. Shaikh H, Khan KS. Adenomyosis in pakistani women: four year experience at the Aga Khan University Medical Centre, Karachi. J Clin Pathol 1990;43(10):817–9. 14. Vercellini P, Parazzini F, Oldani S, Panazza S, Bramante T, Crosignani PG. Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics. Hum Reprod 1995;10(5):1160–2. 15. Parazzini F, Vercellini P, Panazza LC, Chatenoud L, Oldani S, Crosignani PG. Risk factors for adenomyosis. Hum Reprod 1997;12(6), 1275–9. 16. Emge LA. The elusive adenomyosis of the uterus. Am J Obstet Gynecol 1962;83:1541–63. 17. Azziz R. Adenomyosis in pregnancy. J. Reprod Med 1986;31(4):224–7. 18. Matalliotakis IM, Katsikis IK, Panidis DK. Adenomyosis: what is the impact on fertility? Curr Opin Obstet Gynecol 2005;17(3):261–4. 19. Takahashi K, Nagata H, Kitao M. Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis. Nippon Sanka Fujinka Gakkai Zasshi 1989;41(11), 1849–50. 20. Lee NC, Dicker RC, Rubin GL, Ory HW. Confirmation of the preoperative diagnosis for hysterectomy. Am J Obstet Gynecol 1984;150(3):283–7. 21. Kim MH. Dysfunctional uterine bleeding. In: Copeland IJ editor. Textbook of Gynecology 15t ed. WB Saunders Comp 1993;391–7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ağustos 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 8 Sayı: 2 |
